2018 Health Care Outlook: Clay Goddard

Springfield-Greene County Health Department executive director

Clay Goddard began his tenure as Springfield-Greene County Health Department’s new director with the kick off of a mental health needs assessment.

2018 Projection: Uncertainty at the federal level will further emphasize the need for local collaboration. Some federal monies should help fight opioid abuse, but cuts are expected in other areas.

SBJ: Describe the current climate of the health care industry.Goddard: There are so many uncertainties and cloudiness on what the federal government is going to do. And, certainly, that’s not going to change. Here locally, I think what we have is a wonderful, collaborative and cooperative spirit, and it’s really played out with what we’re doing with the community health needs assessment and what we’re doing with the mental health assessment – all of that collaborative work where we can agree on priorities and strategies and address them. So, you have this uncertainty on a federal level, but when you zoom in on Springfield and Greene County and really southwest Missouri, you have a shared vision. And that’s refreshing to me.

SBJ: What is the biggest topic of conversation in the health care community?Goddard: Opioids and mental health are at the top of the heap. But let’s not forget some of those lingering issues. When we did the priorities, we did heart disease, lung and mental health, but identified five common threads that are really woven throughout all these conditions. So when we built our intervention and community health improvement plan, we really built them around those common threads. It’s access to appropriate health care – so that means not receiving your primary health care in an emergency room setting – tobacco use, social determinants, active living, healthy eating and mental health.

SBJ: Do you think the way people – both the community and health care providers – view opioid abuse and the treatment of those patients is changing? Goddard: Southwest Missouri is interesting. On the coast, things happen first and then they always arrive in Springfield last. They’ve been struggling with this out in New Hampshire, Ohio, Kentucky and West Virginia for some time. It’s only a matter of time before these things started to take over here. Obviously, it’s going to dominate the conversation, and the fact that the president (declared an opioid epidemic). We hope that some monies will come with that, some federal monies to really help us develop an approach to help this epidemic locally.

SBJ: How are respiratory and cardiac health impacting Springfield?Goddard: Greene County, as a whole, 24 percent of our citizens smoke. That’s a lot. It’s higher than the state, which is 23 percent. Eleven percent of the entire state of California smokes. If you shrink that into (Springfield) alone, 26.4 percent of our population smokes. Where it gets even crazier is if you look at a couple of neighborhoods that we targeted using small-area estimates. Tom Watkins … it’s up in that northwest quadrant, 36.3 percent of those citizens smoke. Then look at my neighborhood … it’s 13 percent. It’s pretty apparent where we need to do a deep dive and do some really concentrated work.

SBJ: Emergency room overcrowding is another issue. How are you strategizing to meet this need? Goddard: We’re still really in the technical stage of developing strategies and conversations. We don’t have a problem with access to care in our community. Where we have the problem is access to appropriate care and finding primary care for people who don’t have insurance – changing that belief and behavior where people say, “I don’t feel well; I need to go to the ER.” This is going to be a big boulder to move up the mountain, but we hope that, over time, we will come up with good strategies.

SBJ: Considering the possibility of less federal funding, what does the Health Department’s 2018 budget look like?Goddard: Our roughly $10 million annual budget is essentially a three-legged stool, with local, state and federal dollars. It’s not uncommon to see some contraction of funds within those streams, but having three general sources of revenue gives us some overall stability. While there is some uncertainty with what future federal budgets might look like, we feel fairly confident that WIC, our biggest federally funded program, is safe. What could be in danger, and often is, is Public Health Emergency Preparedness funding. If that were to be cut, we would have to absorb some of that cost.